Chelation therapy is a widely practised mode of treatment for atherosclerotic cardiovascular diseases all over the world. However, evidence for the utility of this therapy is limited and conflicting. We did a systematic review of the literature. The reference listings of the articles, obtained from a Pubmed search using relevant keywords, were searched for additional related articles. Most of the evidence supporting the use of EDTA chelation therapy is from case reports, small series or uncontrolled, open-label clinical trials. The published randomized controlled trials include few patients and their results are of limited value. Uncontrolled studies have reported symptomatic improvements but the few controlled trials suggest that these benefits are due to a placebo effect. The available data do not support the use of chelation in cardiovascular diseases. This therapy should be used only in the context of a research trial including patients who have failed to respond to conventional treatment.